Karakalpakstan, UZBEKISTAN
Karakalpakstan is a semi-autonomous republic in Uzbekistan with an area of
165,300 sq. kilometers (half the size of Italy and four times larger than the
Netherlands) and a population of 1.5 million. Karakalpakstan lies in the delta
area of the Amur Darya river and the Aral Sea.

Abstract
The Aral Sea, once one of the world's largest inland freshwater seas, is now a
shrinking sea due to unsustainable water use. The local population used to live
on fishing, commercial shipping, rice growing or cattle herding, but the ongoing
Aral Sea crisis has dramatically affected the health and livelihoods of the 35
million inhabitants of the region. Doctors and NGOs in the region say that there
is a strong link between the environmental crisis and the health problems of
women and children living in the region. Local women and children suffer from
menstrual disorders, anemia, liver diseases, cancer and birth defects. Infant
mortality is said to be the highest in the former Soviet Union (40 to 60 deaths
per 1,000 live births in Karakalpakstan compared with 19 per 1,000 in Russia and
between 7-12 per 1,000 in Europe). Birth defects are also on the increase (27
per 1,000 in Karakalpakstan compared with 3-5 per 1,000 in Europe). There has
been a clear destruction to the region’s economy. The Aral Sea has shrunk to
almost half its orginal size, which has led to the loss of livelihoods of an
estimated 40,000 - 60,000 fishermen and fish-processing workers in the area.
Karakalpakstan is now the poorest region in Uzbekistan and the area hardest hit
by the Aral Sea crisis.

Cause of the Environmental Crisis
The arrival of Soviet developers in the 1930s heralded the destruction of the
age-old system of rice-field irrigation and water pricing and the installation
of a wasteful, large-scale irrigation system. Under the Soviet economic system,
the entire region along the Amu Darya River (Kyrgyzstan, Turkmenistan and
Uzbekistan) was designated for the production of cotton. To ensure the
productivity of the cotton agro-industry, large quantities of water were needed
to irrigate the fields. Thus, the Amu Darya river was dammed at several places
along the river, diverting water that would have ordinarily gone into the Aral
Sea, to irrigate cotton fields instead.

In the 1960s it became apparent that the dams and large-scale irrigation
projects were drawing too much water from the Amu Darya river (which feeds into
the Aral Sea), as the sea was beginning to dry up. The large cotton monoculture
developed by the Soviet regime is the main reason for the dying of the Aral Sea.

Cotton production also led to toxic pollution of the region. Pesticides like DDT
and lindane were used to maximize the total yield of cotton. Defoliants
containing dioxin were used to make it possible for mechanical pickers to
harvest the crop. The use of DDT and lindane has now been banned, however
defoliants and other pesticides are still being used. The entire population
continues to be exposed to chemicals. Often, pesticides are sprayed from
airplanes, which fly over villages and cotton field workers, many of whom are
women. These chemicals have entered the food chain where they bio-accumulate and
are transferred from fatty foods, such as oil and milk, to women who then
transfer the chemicals to their children through their womb and breast-milk.

Reports recently published by the World Bank, the Japanese International
Development Agency (JICA) and UN agencies testify to the immense environmental
pollution problem in the area, particularly water pollution and water
mismanagement. At the UN international meeting on Urgent Human Needs, held in
Tashkent in January 1994 an Uzbek government representative observed that
150,000 tons of toxic chemicals had entered the water over the last 10 years and
that these would continue to pollute soil and water supplies. The report from
the 1995 UN conference on the Aral Sea states, "Once a prime source of
potable water, ground water is no longer suitable for drinking in most
areas."

A 1996 JICA report attributed deterioration of water quality to the discharge of
mineralized water into rivers, highly contaminated with organic and inorganic
substances (nitrogen, phosphorus, pesticides, phenols, etc.). The defoliants
(used on the cotton fields) polluted underground and river water which was used
as drinking water in the downstream areas. In addition ground water was also
used for irrigation, leading to underground salt deposits, thus exacerbating the
salinification of the soil. The 1996 JICA report describes increasing aridity,
as salt crystallized on the dry bed of the sea and on the agricultural land due
to surface water evaporation. Salt dust blown over the surrounding area, caused
damage to agricultural land and adverse effects on people’s health. More than
40% of cultivated land has suffered salt damage.

The inefficient irrigation system installed by the Soviets eventually caused
declining cotton yields and infertile agricultural land. Furthermore, the region
was affected by pollution from upstream, particularly from heavy metals used in
mining and metalworking industries. In the Pamir mountains, dams and large
industrial sites include chromium plants, which emit waste into the Amu Darya
river and chemical and biological weapons factories in Kongrad and Muniak, two
towns in Karakalpakstan, that tested their weapons in the Aral Sea. This toxic
inheritance probably continues to pollute the area.

Impact of the Environmental Crisis
The Aral Sea case is a prime example of how unsustainable water management can
lead to an economic and human disaster. The local people see more and more
community members becoming ill or dying. They see their environment becoming
increasingly hostile as salt crusts on the land thicken, fewer trees grow old,
the growing season is shorter and harvests are lost. They see the places they
used to swim in the sea when they were young, covered by sand. There are no more
fish and the animals and plants are disappearing. They notice how they have less
and less water and how bad it tastes.

The women of Karakalpakstan are worst hit by the environmental crisis, because
women traditionally bear the burden of caring for ill family members. Often it
is the women who are wrongly blamed for illnesses. Two studies (Crosslinks 1994,
Binnies 1996) blamed the high level of anemia, diarrhea and consequent increase
of morbidity and mortality, indirectly on women for not cooking adequately for
their families and not providing their children with a balanced diet and clean
water. Many women in Karakalpakstan work in the kolkhozes (state farms) or are
in the service sectors (doctors, nurses, schoolteachers, etc.) In their spare
time women try to grow some food in their gardens, if they have them and if they
can find sufficient water, which is becoming increasingly difficult.

Health effects on women and children in Karakalpakstan:
Maternal mortality rates are 3 to 4 times higher than the national
average;
99% of women and 90% of children suffer from anemia;
90% of women have complications during pregnancy and deliveries;
16% of pregnant women have miscarriages;
30%of pregnant women have kidney diseases;
there is a high level of certain elements (Mn, Cr, and Cd) in
pregnant women’s blood serum;
there is a low level of essential elements (Fe, Zn) in pregnant
women’s blood serum
Breast milk contains lindane and DDT;
Frequency of birth defects is 5 times higher than in most of
Europe;

A 1995 UNDP report stated that the average infant mortality rate was 4.48%, the
highest in Uzbekistan, which has an average infant mortality rate of 3%. In
1996, a JICA report found infant mortality rates to be 10% in some areas. This
report also found that 6.49% of children below the age of 14 years suffer from
skin diseases and that children are prone to water borne diseases such as
diarrhea and acute respiratory illness.

Health effects on general population of Karakalpakstan:
Viral hepatitis has increased from 62.4 per 1,000 to 94.8 per
1,000 in the past 19 years;
Incidence of tuberculosis is 1.5 times greater than before;
Liver cancer incidence has increased 5 times in the last 10
years; and Skin disease is twice the national level affecting
9.83% of the general population.

The effects of environmental pollution on people are being played down by
government and international agencies. According to these agencies, the causes
of health problems are lack of hygiene and poor diet, rather than environmental
pollution. The population of the Aral Sea region and particularly women and
children, generally suffers from poor health. Part of this is due to a breakdown
in the health care infrastructure since the dissolution of the Soviet Union.
There are repeated outbreaks of infectious diseases and average lifespans are
declining dramatically. This phenomenon is seen in most of the newly independent
states; however, Karakalpakstan and other regions bordering the Aral Sea have
been particularly hard hit. Poor drinking water quality is assumed to have
contributed to documented increases of certain morbidities such as hepatitis,
kidney failure, birth defects and spontaneous abortions (Ataniyazova 1994,
Abdirov 1993).

Anemia is often disregarded since almost 50% of the world’s population suffers
from it, but policy makers must examine the severity of the problem, not just
the occurrence. One out of seven women in Karakalpakstan suffers from severe
hemorrhage (bleeding) during pregnancy which is the main cause of maternal death
(they bleed to death, so to say). A World Bank report (Binnies 1996) relates
hemorrhaging directly to severe anemia. Severe anemia is also found in 60% of
newborn babies. The same 1996 World Bank report relates severe anemia in
newborns to increased fetal morbidity and mortality, impaired language and motor
development and impaired coordination.

Frequent pregnancy and poor diet were considered to be the causes of anemia
among Central Asian women. Thus, programs designed to address anemia have been
directed at regulating the number of births, proper diet and iron
supplementation. However, Dr. Oral Ataniyazova's research has shown that the
high frequency of anemia among women in Karakalpakstan is independent of
pregnancy and age. The study reveals a high frequency of anemia in women who
were not pregnant (92%), teenage girls (87%) and among newborn babies (85%).
This research has shown that environmental factors such as high mineralization
of drinking water have led to anemia amongst women in the Aral Sea region.

Effects on the climate and economy:
The drying up of the Aral Sea and water pollution have led to economic decline
in the region, through loss of resources and productive labor. The Karakalpak
tourism industry along the Aral Sea shore was abandoned in the 1980s. It is
estimated that some 40-60,000 fisher people have lost their livelihoods. While
fishing and related activities once provided 50% of the region’s income, large
fish canning industries now have hardly any fish to process. Species extinction
is taking place with almost 40 fish species in the Aral Sea having become
extinct. The former fish catch of 40,000 tons a year has declined to zero. The
mutagenic activity of the water is 1.5 times higher than in Moscow. Great
numbers of other species (i.e., mammals, birds) have also become extinct.

Under the Soviet system the entire region specialized in growing cotton, which
was then exchanged for wheat and other goods from other areas of the Soviet
Union. This specialization is increasingly problematic for the newly independent
states of the Aral Sea Basin. The quality of Aral Sea Basin cotton is low,
because it has short fibers. Although cotton exports still make up most of the
country's income, cotton sales are declining and the Uzbek government has to
import three million tons of wheat to feed it’s people.

The greatest effects of the Aral Sea crisis are expected to hit the agricultural
sector of Karakalpakstan, where local climate changes and increased salinity are
starting to take their toll. The agricultural output of the region has already
declined by 20-30% due to soil salinity, climate change and reduced labor
productivity stemming from health problems. As a result of the shrinking Aral
Sea, the Karakalpak region suffers increasingly from climate change. The climate
of the Aral Sea basin used to be tempered by the moderating influence of the
enormous water body. Now, temperature changes are wider and more abrupt,
resulting in shorter growing seasons and higher probability of harvest loss.

Response to the Environmental CrisisResponse by Governments and International Agencies
The enormity of the ecological crisis in the Aral Sea basin became more visible
following the dissolution of the Soviet Union. It also became increasingly clear
that no country acting alone could stop the destruction and an interregional
effort of all the riparian states - Uzbekistan, Kazakhstan, Turkmenistan,
Kyrgyzstan and Tajikistan - was necessary. The Heads of State of the five
riparian countries came together to form the Executive Committee of the
Interstate Fund for the Aral Sea (ICAS). Each country contributed to this fund,
for activities to improve the Aral Sea problems. The five countries also asked
the UN and the World Bank for assistance.

In January 1994, the Aral Sea Basin Program was set up in cooperation with the
World Bank, UNEP and UNDP. The objectives of the program were to:
Stabilize the environment of the Aral Sea
basin;
Rehabilitate the disaster zone around the
sea; Improve the management of the
international waters of the Aral Sea basin; and
Build the capacity of the regional
institutions to plan and implement the above programs (ASBP progress
report No. 2, p.1).

The program included seven sub-programs divided into 19 projects. The cost of
implementing these planned projects was estimated at US $470 million. The money
came from donor countries including Japan, Germany, the Netherlands and Kuwait
(progress report No.3, p. 1).

There was a great deal of hope and optimism in 1994, it was the first time that
these five newly independent states had established international relations
independent of Moscow. The governments of the five countries believed that their
problems were the problems of the world and that the world community would help
them solve this crisis. In this state of euphoria, the heads of state of the
Aral Sea riparian countries declared themselves committed to sustainable
development and signed the Nukus Declaration on September 1995 at an UN
International Conference on Sustainable Development of the Aral Sea Basin (ICAS)
held in Nukus. The state leaders acknowledged the need to "Preserve the
quality of life for our peoples, without compromising the life of future
generations by encouraging and supporting initiatives aimed at improvement of
health, income generation and preservation of cultural heritage" (UN ICAS
final report, p.20). They also committed themselves to human development
stating, "As representatives and supporters of the new democratic countries
of Central Asia, we are committed to achieving the participation of our peoples
and NGOs in the overall economic process and in the solution of their
problems." (UN ICAS final report, p.21)

Several million dollars have already been spent on feasibility studies by the
World Bank and more than 131 foreign missions and delegations have visited the
Aral Sea area, discussed the problems, and published articles and reports.
However, no epidemiological studies have been done to look at the links between
the chemical pollution of the region and the health disorders. In 1997, several
World Bank reports stated that it had been shown that there were no health
problems resulting from agrochemicals in Karakalpakstan. The World Bank bases
this conclusion on the 1996 JICA study on water quality of urban drinking water
reservoirs. But the JICA report only measured treated drinking water; it did not
look at untreated water used in rural areas or at other sources of chemical
intake such as cotton oil, used for cooking, or milk. More than half of the test
sites in the JICA report are not those closest to the Aral Sea. Other
measurements are also inconsistent and show major mistakes. For example,
chemical tests for lindane and the DDT breakdown product DDD are indicated in
milligrams per liter, or in grams per liter, whereas they probably meant to
write one-millionth of a gram per liter, as these pesticides are usually
measured.

The World Bank health project’s final report focuses entirely on the
bacteriological health problems in the region. It states that chemical pollution
is not a problem and that if water was indeed chemically polluted,
"experience shows that in such incidents the water usually becomes
undrinkable owing to unacceptable taste, odor and appearance and is not
consumed." (Aral Sea Program 5 project no. 1 Uzbekistan Water Supply
Sanitation and Health Project Final Report Health Aspects, p.5). What is omitted
is that when people have nothing other than polluted water to drink, they will
have to drink it, and that is what is happening in Karakalpakstan. In rural
areas people even use water from the irrigation drainage ditches for drinking
water.

In 1997, a change in strategy occurred. It became clear that the health
dimension bothered officials at the World Bank. World Bank officials wanted to
get on with their work and look for economic projects that would promise a
return on investment from which to start paying back the interests on the loans.
The World Bank officially appeared all too willing to accept the outcomes of
JICA water tests, a few fish analyzed for pollutants, and a graduate student's
study on the causes of anemia. The World Bank transferred the responsibility for
the program to a 2-person team in Tashkent, and decided to reduce the number of
programs and to focus primarily on the agricultural program to improve cotton
production. Health projects were integrated into the water supply program. After
spending around US $2 million, donor countries seem uninterested in giving more
funds to relieve pressing human needs. The UN agency which was supposed to focus
on the human needs issues, the UNDP office in Tashkent, is busy with internal
problems and is in the process of being reorganized.

In Fall 1997, the heads of state of the five riparian countries came together
and, following recommendations from the World Bank, decided that the sea should
be left to die since there was no longer a chance of saving it. Trying to save
the Aral Sea would mean making economic sacrifices that were deemed too great.
This decision was taken without any input from the affected populations. It
could mean that some of the populations living closest to the Aral Sea, like the
Karakalpaks, will now have to leave their towns and villages. A representative
of Doctors Without Borders in Tashkent remarks, "Isn't it just incredible
that five years and $13 million dollars later we are still trying to find out
what pollutants exactly occur in the drinking water of the Aral Sea
region?" The region still does not have a good hospital; there is no
diagnostic center to identify diseases; and no toxicological laboratory where
environmental hazards can be studied.

NGO Response
In most countries, women are society's most experienced and important natural
resource managers. In Karakalpakstan women do most of the agricultural work,
supply water, care for the ill and try to grow sufficient food for their
families. Environmental degradation has added to women's low status in society
by increasing their burdens in an environmentally vulnerable region. Their
children are at increased risk of disease from unsafe water, nutritional
deficiencies and lack of knowledge about prevention. A 1997 UNICEF report on a
children's right to sustainable development states, "Environmental problems
are social problems and the time women spend each day with the ramifications of
environmental decline is time lost to their own development and that of their
children and the wider community. Sustainable development cannot be isolated
from implementing the rights of women to sustainable livelihood and equal
opportunities for education, training, technology, access to credit and decision
making."

With the premise that sustainable development is not possible without the direct
participation of women, the NGO Center-Perzent has initiated a number of
projects in Karakalpakstan. These projects incorporate women's perspective into
the research and analysis of the crisis as well as directly involve them in
programs such as health education and organic food farming. The following
initiatives are being undertaken by Center-Perzent in collaboration with
international networks.

Research
Center-Perzent conducts research to assess the quality of environment and human
health in the Aral Sea region. In collaboration with the NGO ECOLOGIA, Center-Perzent
has engaged the public in monitoring water quality, made recommendations on how
to improve household water quality and developed several workshops with local
authorities and physicians on water quality and health problems.
In collaboration with the Russian Scientific Center of Obstetrics and
Gynecology, Center-Perzent is investigating the epidemiology of reproductive
pathology and reproductive toxicity. In collaboration with the Laboratory of
Ecology and Evaluation at the Russian Academy of Sience, Center Perzent
investigated the level of pesticides in food, soil, water andnursing women’s
breast milk in Karakalpakstan. In cooperation with World Resources Institute,
Center-Perzent is developing an investigation on reproductive health indicators.
This project covers several countries including Brazil, Mexico and Uzbekistan.
Center-Perzent is also receiving assistance from an international team of
experts to carry out research in the Karakalpak region and to identify problem
areas, thus reducing the population’s exposure to contaminants.

Education and Community Awareness
There is a need for enhanced community participation, self-sufficiency, and
empowerment in Karakalpakstan. Center-Perzent has chosen a strategy of
education, information and training as the central components of moving towards
this goal. In its first year of existence Perzent brought out a series of five
booklets on women's health, providing basic information on hygiene, diet, the
functioning of a woman's body, ways of contraception, the needs of pregnant
women and how to take care of newborn babies. The booklets were printed in the
Karakalpak language and distributed in hospitals. The NGO also publishes a
women's newsletter, as well as booklets on "a safe childhood" and the
relationship between health and environment.

Center-Perzent has an environmental education program for 200 children in Nukus
schools. It established an ecological club “Shagala” for children and has an
environmental librasy open to the public. In collaboration with Save the
Children Fund, Center-Perzent has a program which provides water filters to
kindergartens and environmental educational programs for pre-school children.

Since 1996 Center-Perzent has been running a ‘women, health and environment’
project with Women in Europe for a Common Future and partners in Russia and the
Ukraine. As part of this project a group of 20 women from five towns in
Karakalpakstan have been trained on basic health and health and environment
issues. They are now conducting workshops for women in their communities and run
a 'health-desk' where people can come for advice and information.

It is crucial for education and information projects to be interactive, and not
to use a top-town approach. Often women have a lot of knowledge of the local
environment and resources that has been handed down through the generations. The
key is to revitalize that knowledge to improve the current situation.

Community Projects Build Self Sufficiency
Center-Perzent has recently set up the project ‘Sustainable Chimbay,’ a
self-help, organic vegetable and fruit farming program to improve women’s and
children’s diet and avoid further contamination. The local authorities in the
town of Chimbay provided 20 hectares of land for the organic farm.

The goal is to use the vegetables and fruits from this farm in meals served at
the school, thereby improving the health of the children. Another part of the
harvest will be used to improve the women’s diet, particularly pregnant women.
If the harvest is good, the families of participating women will consume the
surplus food and sell the rest. The income from the sales will be used for the
target group's most serious needs, such as securing additional food, repairing
the kindergarten's heating system, building a hand pump, filtering drinking
water and obtaining medicines and syringes for the children's clinic. The
project also includes plans of capacity building training for women who work on
the farm. The training sessions will look at methods of organic farming and
methods to reduce exposure to pollution and improve personal health including
hygiene, diet and water purification.

The main aim of the Sustainable Chimbay project is to show that organic farming
is a viable alternative to pesticide intensive farming. It will improve the diet
of children and families in Chimbay and offer income-generating opportunities
for women farmers and the staff at the training center. The project will become
a training and education center for surrounding farming communities. Thus the
"kindergarten-farm" will gradually become a demonstration farm where
local farmers and Kolkhoz directors can see how different crops can be
cultivated with good yields using organic methods. Furthermore, the
demonstration farm can serve as an experimental center to test new species of
plants which can regenerate the soil, adapt to saline soils and require less
water. Also, the cultivation of organic cotton in rotation with other crops will
hopefully become a pilot project in this demonstration center.

For the last 50 years the local population has been conditioned against
undertaking any individual action. All responsibility for society’s well being
was the domain of the state. The local population appears to think that someone
will come and solve all the problems for them. Local communities need to realize
that they possess the power to improve their environment and their lives. It is
in this context that projects promoting self-sufficiency, like the organic farm
in Chimbay, take on a greater significance.

Recommendations for Action
Based on the experience in the Aral Sea region, the following recommendations
are made:

Make Women’s Health a Priority
Women and children are the main victims of the Aral Sea crisis and they cannot
be expected to bear the increasingly high cost of health care. Therefore, we
call on donors of international aid and credit projects to create a special fund
with grants to pay for health care and monitoring programs, using a gender
differentiated approach with special attention to the health impact on women and
children.

Make Environmental Health a Priority
The Aral Sea case shows that there is a need to create a training program for
staff of the World Bank and other international agencies on the links between
health and the environment. In addition and parallel to existing expertise on
bacteriological health issues, expertise is needed in toxicology and
epidemiology. Therefore, we call on donors of international aid and credit
projects to engage environmental health experts and dedicate funds for research
on environmental health effects, as well as funds for practical projects working
on ways to reduce this impact.Increase Funding to Women's NGOs
"National and local NGOs are at the cutting edge of the environmental
movement and no government or international agency can afford to ignore their
critical contribution," according to a 1997 UNICEF report. In countries
with a history of authoritarian rule, NGOs are often the only ones trusted by
communities. NGOs with strong participation of women can motivate and mobilize
communities to understand the health and other harmful effects of their
activities and show how this can be changed. The World Bank and other
international agencies working in Uzbekistan have made some attempts at working
with NGOs but the proportion of funds dedicated to working with NGOs is a
fraction (0.25%) of total funds spent. Therefore, we call on donors of
international aid and credit projects to set apart at least 5% of total funds
for grants to community-based NGO projects, with specific attention to the
participation of women.

Create an International Independent Assessment Committee
The responses to the Aral Sea problem have been marked by the misallocated
expenditures of funds. To prevent further misallocation, an International
Independent Assessment Committee should be created to monitor and assess the
international programs on the Aral Sea, involving local and international
scientists and NGO representatives.

Create a UN Fund for Ecological Disaster Zones
Environmental pollution and resource mismanagement of fresh water bodies like
the Amu Darya river and Aral Sea can cause the devastation of a region and its
people. The UN should develop international agreements to avoid the devastation
of one region's livelihoods by pollution from other regions. The UN has a role
to play that is similar to its peace keeping function.

Beyond developing international conventions, the UN needs to assist the affected
people in cleaning and regenerating their region. How can such regions repay
loans if their resources have been severely damaged and are increasingly
unproductive? We call on the UN to create a fund for grants to pay for clean-up,
resource regeneration and health care in ecological catastrophe areas like the
Aral Sea Region.

Integrate Agricultural, Environmental and Health Policies
After five years and such high expenditures, there still has not been any
scientific analysis of the contaminants in the air, soil, water and food of the
Aral Sea region. The World Bank and UNDP need to integrate their research, for
example, the agricultural department has data which the health department has
not looked at.

Governments must ensure that policies and programs to fulfill people’s basic
needs such as clean water and their right to know what is harmful to their
health. It is inappropriate to place trust in a trickle-down approach and more
attention must be given to UNICEF’s recommendations and utilizing a bottom-up
approach that involves women’s NGOs.

Humanitarian Aid
International agencies, including the World Bank, UNDP and UN, need to create a
fund for humanitarian aid to this region. Above all, international agencies need
to treat the Aral Sea Basin with the same urgency that they would treat a war or
earthquake zone. The Aral Sea region is an environmental disaster area in need
of immediate assistance.

Case Prepared by:Center-Perzent is an NGO based in Nukus, the capital
of the semi-autonomous republic of Karakalpakstan in Uzbekistan. The goal of
Perzent (a Karakalpak word meaning "progeny") is to unite the
strengths of organizations and progressive people seeking to improve the status
and health of women and children by empowering local women's groups.
Contact: Dr. Oral Ataniyazova
P.O. Box 27
Nukus-12, Karakalpakstan, Uzbekistan
Tel: (7-361) 227-5517; Fax: (7-95) 251-7617
E-mail: perzent@center.nukus.silk.orgWomen in Europe for a Common Future, an NGO based in
the Netherlands, networks women working on environment and health in Western and
Eastern Europe and the Newly Independent States. Its primary aims are to link
European women’s organizations and networks that promote sustainable
development and to strengthen their decision-making power in environmental and
health policies.